Zarnow: Sports injuries pain surgeon

Aug. 19, 2013

Updated Aug. 21, 2013 12:28 p.m.

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Dr. Michael Shepard is with the Orthopaedic Specialty Institute in Orange. PAUL BERSEBACH, ORANGE COUNTY REGISTER

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Dr. Michael Shepard checks the ACL of patient Hailey Stenberg at his office in Orange. Stenberg is a high school and club soccer player who tore her ACL six months ago. PAUL BERSEBACH, ORANGE COUNTY REGISTER

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Dr. Michael Shepard reviews an X-ray with patient Jack Emerson and his dad Barry Van Sickle at his office in Orange. Emerson broke his finger in a trampoline accident. PAUL BERSEBACH, ORANGE COUNTY REGISTER

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Dr. Michael practices sports medicine, arthroscopic surgery, knee, elbow and shoulder reconstruction with the Orthopaedic Specialty Institute in Orange. Shown above with a model of a shoulder joint at his office in Orange. PAUL BERSEBACH, ORANGE COUNTY REGISTER

Dr. Michael Shepard is with the Orthopaedic Specialty Institute in Orange. PAUL BERSEBACH, ORANGE COUNTY REGISTER

As football season gets underway, Michael Shepard will be spending a lot of time on the sidelines.

He'll be watching 30 or 40 games at Santa Ana College, Chapman University and Servite High School – not that he's partial only to football.

He was in Poland last month among 10,000 spectators watching the U.S. Men's National Volleyball Team in the World League. Soon he'll be in Japan with the women's team. At UC Irvine, he watches baseball, soccer or basketball, depending on the season.

Shepard isn't a sports nut with too much time on his hands. An orthopedic surgeon with Hoag Orthopedic Institute in Irvine, he specializes in sports medicine.

For 11 seasons, he's volunteered as team doctor for a variety of schools – putting 11 years of medical training to use, he says, by caring for athletes.

Shepard is the safety net or the air bag: Someone you never hope to see rushing toward you.

Shepard talks about the body like the tires on a car. How many revolutions have you got before you've worn out the tread?

The key, he says, is rotation.

“Players today are more one-dimensional – a baseball player who will only pitch – but there's only a certain number of throws in that arm.”

Unfortunately, many players don't rotate sports by the season. They specialize.

He treats “thrower's elbows” or shoulders in athletes who play only baseball, water polo or volleyball. He's seeing more female athletes tearing their ACL, a knee ligament.

Today children start sports younger than ever and play only one sport all year round – it's practically mandatory to be competitive in high school. As a result, Shepard's patients are younger and their injuries more severe.

“I see 8-year-olds who play year-round baseball.”

He's seeing baseball elbow injuries younger. An 11-year-old patient who tore a ligament in his elbow pitching year round cannot even have surgery until he's finished growing.

The risk of injury increases with the number of hours played.

“Year-round anything is bad,” says Shepard, who thinks it's safer to play multiple sports until high school – or, at least, play different positions in one sport.

“People who are focused on doing one thing over and over are more apt to have problems, and they are more apt to burn out. And then they end up in my office at age 15 or 16 saying: ‘I don't want to play any more.' It's no longer fun.”

The odds are low that a particular child will play professionally. So why the push to become an elite player?

Shepard sees students and their parents invest everything in a sport.

“The family isn't celebrating Thanksgiving; they're in Palm Springs for a tournament. Their whole life is around that sport, and if the child stops playing, sometimes that family unravels.”

Shepard, 43, has been sidelined himself.

He played football at Foothill High School in Tustin and was defensive tackle and captain of the football team at UC Davis.

The first game of his senior year at Davis, he hurt the ligaments in his knee. The sixth game, he tore his ACL.

“The quarterback moved, I moved, but my knee didn't. I turned and I tore it.”

His career was over, and he didn't handle it very well.

“I was devastated. That was hard for 20-year-old Mike Shepard to handle.”

Today, that gives him a strong dose of empathy and can make him a lousy fan.

Shepard describes a 15-year-old soccer player who tore every ligament in his knee. He underwent two surgeries to repair and reconstruct his ligaments and then 18 months of rehabilitation.

“The nerve was gray. It looked dead. … It took him six months just to wiggle his toes.”

He could have lost his leg, but the boy was lucky; he healed. Still, he will never be 100 percent.

“Do we let him go back to play? Do we take the chance? We had lots of long conversations.”

This patient returned to soccer, and he was fine. Shepard was not.

“It was so hard for me to watch him play. I was so scared.”

He finds it excruciating to watch an athlete compete after he has operated. He recalls seeing a college-age patient pitch after elbow reconstruction. “The coach promised he wouldn't throw more than 100 pitches. By the sixth inning, he was already over 110 pitches. … I left the game. I was dying watching.”

Shepard specializes in repairing elbows, shoulders and knees.

He also teaches athletic trainers, who can play a role in preventing injuries and advocate with coaches on behalf of players.

There's psychology to his job: He tries to take the negative of suffering an injury and turn it into a positive. He has a soft spot for college athletes whose main focus is getting an education. He tries to make patients realize that their identity encompasses more than, say, “volleyball player.” They can remain an athlete but play a different sport.

If there is buyer's remorse in athletics, it's the problems injuries lead to later. Some injuries just can't be fixed and some lay the groundwork for lifelong issues such as arthritis.

Shepard notes that you can remodel but not regenerate cartilage. Knee replacements, like granite countertops, are showing up everywhere.

These are sobering thoughts for parents considering whether their child should play club sports.

Shepard asks: “Are we doing that 10-year-old athlete a disservice by patching him up and sending him back in?”

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